Enlargement of the spleen or splenomegaly

Enlargement of the spleen (or splenomegaly) is caused by many medical conditions. These are mainly chronic infections and cancer.

The spleen is a small organ on the left side of the abdomen under the rib cage. The spleen is the size of a fist and supports some functions of the human body.


Causes of enlargement of the spleen

Many diseases affect the functioning of the spleen and cause swelling. The causes of liver and spleen enlargement are classified into several groups:

  • Infections (brucellosis (1), endocarditis (2), hepatitis B or C, HIV, etc.)
  • Cancer (leukemia, lymphoma or pancreatic tumor)
  • Amyloidosis (5)
  • Sarcoidosis (6)
  • Anemia or thalassemia

The infections are divided into:

  • viral infections (mononucleosis),
  • parasitic infections (malaria (7),
  • bacterial infections (syphilis (8) ).

The secondary swelling of the spleen occurs in an infection as a defense mechanism of the body to fight the pathogenic pathogen.

Some types of tumors, such as leukemia and Hodgkin’s disease, are diagnosed when the first symptoms appear on the spleen.
Any type of cancer that spreads in the spleen can damage it and cause swelling.
Premature destruction of red blood cells by anemia enlarges the size of the spleen.
There are some metabolic disorders such as Gaucher’s disease, Niemann-Pick disease and Hurler syndrome that cause spleen enlargement.

A flow obstacle can lead to swelling of this organ.
In people suffering from decompensated heart failure, the pressure on the splenic vein is high.
This leads to an increase in the size of the liver and spleen.
Some inflammatory diseases, such as rheumatoid arthritis and sarcoidosis, cause enlargement of the spleen.
Mechanical injuries of this organ lead to enlargement of the spleen.

Symptoms of spleen enlargement

An enlargement of the spleen does not always have to be a cause for concern.
As a result, the following main symptoms arise:

  • Pain in the left flank, radiating to the abdomen and back
  • Feeling full, only in children
  • Unexplained weight loss
  • Common infections
  • Anemia (decreased red blood cells)
  • High fever in case of infection or intermittent fever if the patient is ill with mononucleosis; this symptom also exists with cirrhosis, leukemia and thrombotic thrombocytopenic purpura
  • Frequent bleeding
  • Fatigue, inexplicable fatigue

Enlargement of the spleen in children

Enlargement of the spleen in children is caused by:

  • Mediterranean anemia or microcythemia,
  • Cancer
  • other infections.

Diagnosis of spleen enlargement

Doctors can diagnose enlargement of the spleen in children very easily.
A doctor suspects that there is a problem with this organ if the patient complains of bloating in the stomach without having eaten anything.
The doctor palpates the size of the spleen on palpation in the left upper region of the abdomen. In order to confirm an existing splenomegaly (enlargement of the spleen), doctors order an in-depth diagnosis (examination):

High transaminases, high erythrocyte sedimentation (BKS) and spleen enlargement indicate mononucleosis.
With mononucleosis and anemia, it can be seen that indirect bilirubin is also elevated.
If the doctor suspects cancer such as leukemia or lymphoma, he may order a bone marrow collection to analyze the cells.

  • Radiogram
  • CT
  • Echography
  • Magnetic resonance imaging (shows the course of blood flow in the spleen)

One studies the images to determine the increase in spleen size.

When to worry?

The patient undergoes a blood test to determine the number of red and white blood cells, as well as platelets.

  1. In leukemia, white blood cells are high, but red blood cells and platelets are lowered.
  2. In hypersplenia syndrome and Gaucher disease, blood tests show decreased white and red blood cells and a lack of platelets (thrombocytopenia).

How big is the healthy spleen in adults and children?

AgeSize of the spleen in cm
(less than or equal to)
3 months6
6 months6.5
12 months7
2 years8
4 years9
6 years9.5
8 years10
10 years11
12 years11.5
15 – 20 years12 (for women) 13 (for men)

What should you do? Therapy for splenomegaly (enlargement of the spleen)

Treatment of splenomegaly depends on the cause of the underlying disease.

Antibiotics are prescribed for bacterial infections, in pregnancy you should talk to the doctor before taking medication.

The patient may undergo chemotherapy treatments or radiation therapy if leukemia or Hodgkin’s disease causes the enlargement of the spleen.
Until healing, rest and avoiding stress, which can affect immune protection, is recommended.

Surgery of the spleen is recommended only if it is not possible to identify the cause.
Surgical intervention is indicated in chronic diseases, when the patient does not respond to the necessary treatment and needs blood transfusions.
In these cases, parts of the spleen or the entire organ can be removed.
Removal of the spleen does not cure the disease, but reduces the effect of lowered leukocytes.

Complications of spleen enlargement include rupture of the spleen. In this case, the spleen must be surgically removed as soon as possible (splenectomy), as this lesion can be fatal.
Surgical removal of the spleen is the last option.
A person can live without a spleen, but the possibility of severe infection is increased.

To reduce the risk of infection to a minimum, vaccinations are recommended before and after removal of the spleen.
These injections are used to protect against pneumonia, meningitis and infections of the bones, joints, blood and lungs.
Some patients need to take penicillin before and after surgery.

Natural remedies for enlarged spleen

In case of problems with the spleen, it is important to follow a healthy diet or diet. Foods to avoid are:

  • Dairy products
  • fried foods,
  • Alcohol
  • sweetened drinks and confectionery found in supermarkets.

Fruits, vegetables, legumes and other herbal products not treated by humans are recommended.

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